Credit Application

Thank you for your interest in financing through Graybar Financial Services (GFS). Please note that you are submitting credit information that, if approved, can only be used to lease or finance equipment through GFS. Important! This is not an application for a new Graybar Electric account.

Please fill out as much of the form as you can. When you are finished click on the "Submit" button. You should receive a response within one business day. If you would prefer, you may print out the application and fax it to us at 800-543-0274.

If you have any questions, don't hesitate to call us at 800-241-7408.

Business Information

Business Name (Legal name)*

Company Street Address*

Company City*

State*

Zip Code*

Legal Structure

Federal Tax ID

If the equipment address is different than the business address, check here.

Equipment Address

Equipment City

Equipment State

Zip Code

Principal/Owner

Name

Title

Phone Number

Email Address

Equipment Information

$ Estimate Equipment Cost

Equipment Type

Equipment Type (If Other)

Required Finance Term

Vendor Information

Equipment Provider

Sales Rep Name

Equipment Provider Email

Phone Number

Terms and Conditions

If your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain the statement, please contact Credit Disclosure Administrator, Graybar Financial Services, 11885 Lackland Road, St. Louis, MO 63146, 800-241-7408 within 60 days from the date you are notified of the credit decision. We will send you a written statement of reasons for the denial of credit within 30 days of receiving your request for the statement.

Notice: The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant's income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning the credit is the Federal Trade Commission, Equal Credit Opportunity, Washington, DC 20580.

This page contains a notice required under the Equal Credit Opportunity Act. The Lessee is entitled to receive and retain a copy of this notice. When an application for business credit is made solely by telephone, compliance with the notice requirements may be satisfied by oral disclosure of the applicant's right to a statement of the reasons for a denial of credit.